Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates.

Introduction

In every facet of healthcare, nurses, midwives, and nursing associates serve as the caring stewards of patients’ wellbeing. Their unwavering dedication to providing quality care and upholding professional integrity forms the bedrock of a thriving healthcare system. Professional standards of conduct and behaviour are a set of fundamental concepts that form the basis of this dedication.

With the goal of assuring the provision of great care and upholding the highest ethical standards, we set out on a journey in this blog to examine the significance of professional standards in nursing including the definition and purpose of professional standards, the standards of professional nursing practice, the standards of professional performance, nursing scope and standards of practice, and the nursing code of ethics.

As we examine the fundamental elements of these standards, we will see how they act as a lighthouse for healthcare professionals, illuminating the way to excellence in patient care and other areas as well. As the world of medicine continues to evolve, so does the importance of adhering to these principles. From upholding patient confidentiality and communication skills to embracing cultural diversity and continuous self-improvement, the multifaceted nature of professional standards in nursing shapes a transformative landscape for the entire healthcare community.

Professionalism in nursing reflects the act of providing quality patient care while honouring the values of respect, advocacy, and responsibility. Nurses who conduct themselves with professional attitudes and behaviours are instrumental in building strong interdisciplinary relationships, resulting in better patient care, improved patient outcomes, and higher patient and employee satisfaction and retention rates.

The standards of professional nursing practice are authoritative statements that define the actions and behaviours expected of all registered nurses, regardless of role, population, or specialty. These standards are critical in guiding nurses’ actions and behaviours and include the critical thinking model of the nursing process and its components. The standards of professional performance outline a nurse’s professional behaviour and include activities related to ethics, advocacy, communication, collaboration, leadership, and more.

Professional Standards of Practice and Behaviour for Nurses, Midwives, and Nursing Associates

Professional standards of practice and behaviour are essential in nursing to ensure quality care and maintain professional integrity. These standards are authoritative statements that define the actions and behaviours expected of all registered nurses, regardless of role, population, or specialty. The main purpose of professional standards is to direct and maintain safe and clinically competent nursing practice.

The standards of professional nursing practice define diagnostic, intervention, and evaluation competencies. They reflect a desired and achievable level of performance against which a nurse’s actual performance can be compared. The critical thinking model of the nursing process and its components are also included in these standards.

The Code

The Code presents the professional standards that nurses, midwives and nursing associates must uphold in order to be registered to practise in the UK.

It’s structured around four themes – prioritise people, practise effectively, preserve safety and promote professionalism and trust.

Each section contains a series of statements that taken together signify what good nursing and midwifery practice looks like.

You’ll see that we’ve changed the look of the Code. This is in line with some changes we’ve made to our visual identity to be more accessible, modern and to help us communicate better with you. Importantly, the content of the Code hasn’t changed, so you can continue to use your existing copy if you’ve already printed it.

The Code is available at https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf

Below are the four standards that nurses, midwives, and nursing associates are expected to uphold according to the Code.

Prioritise People

The interest of the people in need of the services of nurses, midwives, and nursing associates must remain a priority. Hence, people must be set as a priority and treated with the utmost respect. The Code requires nursing professionals to make the care and safety of patients in need of their services their main concerns. The dignity of the patients must be preserved; their needs must be recognised, assessed and responded to.

Other essential parts of prioritising people are to accord them important respects without infringing on their rights. There shouldn’t be any ounce of discrimination towards those who are receiving care, whether old or young, poor or rich, white or black. It can be summarised further as:

• Treat people as individuals and uphold their dignity
• Act in the best interests of people at all times
• Respect people’s right to privacy and confidentiality
• Listen to people and respond to their preferences and concerns

Practise Effectively

Nursing professionals are required to assess and deliver or advise on treatment or give help without delay. These include both preventative and rehabilitative care based on the best available evidence and to the best of their abilities. Nurses, midwives and nursing associates are to communicate effectively by keeping clear and accurate records.

More so, when reviews and feedback are given, nursing professionals are to reflect on them thoroughly to make amends where necessary. It can be summarised further as:

• Always practise in line with the best available evidence
• Communicate clearly
• Work co-operatively
• Keep clear and accurate records relevant to the practice

Preserve Safety

According to the Code, nursing professionals are to ensure the safety of patients and as well as the preservation of public safety. They are to work within the limits of their competence, exercise their professional expertise and notifying others immediately whenever they come across situations that threaten the safety of patients and the general public. It can be summarised further as:

• Relevant safety plans appropriate for their practices
• Recognise and work within the limits of their competence
• Act without delay when there are potential risks to patients and public safety
• Promote Professionalism and Trust

Nurses, midwives, and nursing associates are to uphold the reputation of their profession at all times with personal commitment to the standards of practice and behaviour. They are expected to be a model of integrity and leadership for the general public. It can be summarised further as:

• Respond to any complaints from patients professionally
• Provide leadership to preserve people’s safety and well-being
• Fulfil all the registration requirements

The Importance of Professional Standards in Nursing

Professional standards of practice and behaviour are essential in nursing to ensure quality care and maintain professional integrity. These standards are authoritative statements that define the actions and behaviours expected of all registered nurses, regardless of role, population, or specialty. The main purpose of professional standards is to direct and maintain safe and clinically competent nursing practice.

The standards of professional nursing practice define diagnostic, intervention, and evaluation competencies. They reflect a desired and achievable level of performance against which a nurse’s actual performance can be compared. The critical thinking model of the nursing process and its components are also included in these standards.

The standards of professional performance outline a nurse’s professional behaviour and include activities related to ethics, advocacy, communication, collaboration, leadership, and more. These standards are important to the nursing profession because they promote and guide clinical practice. They provide an evaluation tool for nurses to ensure clinical proficiency and safety. Professional nursing standards are also used to provide a framework for developing clinical competency checklists or proficiency evaluations for a specific clinical unit or employer.

Here are some examples of how these standards are applied in nursing practice:

Ethics: Nurses must adhere to ethical principles such as autonomy, beneficence, justice, and non-maleficence. They must also be aware of ethical issues that may arise in their practice and be prepared to address them.

Advocacy: Nurses must act as patient advocates, protecting the rights, health, and safety of their patients. They must also advocate for the nursing profession and work to advance the profession and patient care through legislative and political advocacy.

Communication: Effective communication is essential in nursing to ensure patient-centered care and collaboration with colleagues and other healthcare professionals. Nurses must be proficient in communication skills, including nonverbal communication, active listening, and personal relationships.

Collaboration: Collaboration among nurses and other healthcare professionals ensures more efficient, effective patient care and a more supportive environment where team members can develop in their practice. Nurses must be relentless in pursuing and fostering true collaboration.

Leadership: Nurses must demonstrate leadership in the professional practice setting and the profession. They must also be prepared to take on leadership roles and mentor others in their practice.

Professional development: Nurses must engage in ongoing professional development to maintain clinical proficiency and promote professional growth.

Upholding and adhering to these standards is crucial for maintaining professional integrity and promoting professional growth. Nurses who conduct themselves with professional attitudes and behaviours are instrumental in building strong interdisciplinary relationships, resulting in better patient care, improved patient outcomes, and higher patient and employee satisfaction and retention rates.

Conclusion

In conclusion, professional standards of practice and behaviour are essential in nursing to ensure quality care and maintain professional integrity. Upholding and adhering to these standards is crucial for promoting patient safety, maintaining professional integrity, and promoting professional growth.

The standards of professional nursing practice define diagnostic, intervention, and evaluation competencies, and the critical thinking model of the nursing process and its components are also included in these standards. The standards of professional performance outline a nurse’s professional behaviour and include activities related to ethics, advocacy, communication, collaboration, leadership, and more.

The nursing code of ethics provides a framework for carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession. It helps nurses navigate complex ethical dilemmas and provides a basis for evaluating the performance of nurses in their practice.

Overall, professional standards of practice and behaviour are essential in nursing to ensure quality care and patient safety. We encourage all nurses, midwives, and nursing associates to uphold and adhere to these standards in their practice to promote the highest level of care and maintain professional integrity.

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Purposeful Hourly Rounding

Purposeful hourly rounding involves checking on the patient every hour during the day and every 2 hours overnight. It is intended to proactively address a patient’s needs. A structured approach involves addressing the “4 Ps” during each rounding visit. Hourly rounding with the 4 P’s has been shown to have a positive impact on patient care and satisfaction, reducing falls, reducing skin breakdown, and improving patient perception of care. Some sources mention a fifth P, “Personal Needs,” which includes hydration and nutrition. It is important to note that the 4 P’s of nursing should not be confused with the 4 P’s of marketing, which are Product, Price, Place, and Promotion.

What is the significance of each of the 4 P’s of nursing in patient care?

The 4 P’s of nursing are Pain, Potty, Positioning, and Periphery. Here is the significance of each of the 4 P’s of nursing in patient care:

Pain: Checking if the patient is experiencing any pain and if it is controlled is important because pain can negatively impact patient outcomes and satisfaction. By addressing pain proactively, nurses can prevent potential issues and improve patient comfort and well-being.

Potty: Checking if the patient needs to use the restroom or needs any assistance with personal needs such as hydration or nutrition is important because it helps prevent falls, skin breakdown, and other complications that can arise from immobility or neglecting personal needs. By addressing potty needs proactively, nurses can also improve patient dignity and comfort.

Positioning: Checking if the patient is comfortable and if they need any assistance with repositioning or getting up is important because immobility can lead to pressure ulcers, pneumonia, and other complications. By addressing positioning needs proactively, nurses can prevent potential issues and improve patient comfort and mobility.

Periphery: Checking if the patient has everything they need within reach, such as the call light, telephone, TV remote, bed light, bedside table, and tissues, is important because it helps prevent patient frustration and anxiety. By addressing periphery needs proactively, nurses can also improve patient satisfaction and perception of care.

How do the 4 P’s of Nursing help improve patient care?

The 4 P’s of nursing, which are Pain, Potty, Positioning, and Periphery, help improve patient care by providing a structured approach to hourly rounding. Hourly rounding with the 4 P’s has been shown to have a positive impact on patient care and satisfaction, reducing falls, reducing skin breakdown, and improving patient perception of care. By checking if the patient is experiencing any pain and if it is controlled, if the patient needs to use the restroom or needs any assistance with personal needs such as hydration or nutrition, if the patient is comfortable and if they need any assistance with repositioning or getting up, and if the patient has everything they need within reach, such as the call light, telephone, TV remote, bed light, bedside table, and tissues, nurses can address patient needs proactively and prevent potential issues. Hourly rounding with the 4 P’s also helps nurses prioritize tasks and manage their time more efficiently, reducing the number of pages to physicians and increasing nursing and physician satisfaction.

Purposeful hourly rounding

What are some challenges that nurses may face when implementing the 4 P’s of nursing in a hospital setting?

Implementing the 4 P’s of nursing in a hospital setting can present some challenges for nurses. Here are some examples:

Time management: Implementing hourly rounding with the 4 P’s can be time-consuming and may require nurses to adjust their schedules and routines. Nurses may need to prioritize tasks and manage their time more efficiently to ensure they can complete their rounds and other duties.

Resistance to change: Some nurses may be resistant to change and may not see the value in implementing the 4 P’s of nursing. It is important to educate and train nurses on the benefits of hourly rounding with the 4 P’s and how it can improve patient care and satisfaction.

Communication barriers: Communication barriers between nurses and patients can hinder the implementation of the 4 P’s of nursing. Nurses may need to use clear and concise language and ensure patients understand the purpose of hourly rounding and the 4 P’s.

Staffing levels: Staffing levels can impact the implementation of the 4 P’s of nursing. If there are not enough nurses available to complete hourly rounds, patients may not receive the care they need.

Are there any strategies or best practices for overcoming challenges in implementing the 4 P’s of nursing in a hospital setting?

Yes! Here are some strategies and best practices for overcoming challenges in implementing the 4 P’s of nursing in a hospital setting:

Education and training: Providing education and training to nurses on the benefits of hourly rounding with the 4 P’s and how it can improve patient care and satisfaction can help overcome resistance to change and ensure consistent implementation.

Efficiency and time management: Encouraging nurses to be mindful of efficiency and time management during rounds, such as clustering care and adjusting schedules and routines, can help overcome time management challenges.

Communication and patient engagement: Improving communication with patients and engaging them in the hourly rounding process can help overcome communication barriers and improve patient satisfaction.

Staffing levels: Ensuring adequate staffing levels can help overcome staffing challenges and ensure patients receive the care they need.

Adaptation and customization: Adapting and customizing the 4 P’s of nursing to fit the unique needs and challenges of each hospital and patient population can help ensure successful implementation and improve patient outcomes.

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